ABSTRACT
This chapter discussed one of the most common objections to the use of cost-effectiveness analysis for the allocation of health care resources. According to this objection, the use of cost-effectiveness calculations leads to unfair discrimination against people with disabilities. We showed that various formulations of this objection are based on confusing quality of life with the value of life or misunderstanding what cost-effectiveness analysis is and how it works in practice.
We did, however, identify a different moral problem: it is possible that interventions for some disability have unfavorable cost-effectiveness ratios, and thus the people living with that disability would be disadvantaged because the interventions are not provided to them. We looked at different theories of what makes discrimination unfair, but found that none of them can accommodate this kind of case. In the end, we suggested that the moral problem raised by the case should be addressed by giving more weight to the benefits of worse-off patients.
